Proposta de escore preditivo de recorrência em pacientes submetidas a tratamento cirúrgico radical do carcinoma do colo do útero estádios IB e IIA

Fregnani, José Humberto Tavares Guerreiro

doi:10.1590/s0100-72032003000900013

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“…The number of lymph nodes involved has also been described as a risk factor for recurrence, and progressively shorter disease-free survival with increasing numbers of lymph node metastases has been noted. 17 , 30 - 34 In the present sample, the recurrence risk became progressively greater with increasing numbers of metastatic pelvic lymph nodes.…”

Section: Discussionmentioning

confidence: 56%

“…The literature describes a variety of risk factors for recurrence of carcinoma of the uterine cervix in its initial stages, such as the presence of metastases in lymph nodes, tumor size, depth of invasion into the cervical stroma, invasion of the parametrium, histological type, degree of cell differentiation, blood capillary embolization and lymphatic capillary embolization, among others. 8 The intensity of the inflammatory reaction in the uterine cervix consequent to carcinoma has been indicated as a risk factor for recurrence. If on the one hand some authors have observed increased risk of recurrence when the inflammatory reaction was weak, 9 - 21 others have described discordant results.…”

Section: Introductionmentioning

confidence: 99%

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Intensity of cervical inflammatory reaction as a risk factor for recurrence of carcinoma of the uterine cervix in stages IB and IIA

et al. 2007

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CONTEXT AND OBJECTIVE: Inflammatory reaction intensity has been indicated as a possible recurrence risk factor in carcinoma of the uterine cervix. Some authors observed greater risk with weak inflammatory reaction, while others described the opposite. This study aimed to evaluate risk factors for initial-stage uterine cervix carcinoma recurrence (IB and IIA), considering inflammatory reaction intensity. DESIGN AND SETTING: Retrospective cohort at Hospital do Câncer A. C. Camargo. METHODS: 289 patients with diagnosed uterine cervix carcinoma (stages IB and IIA) who underwent radical surgery between 1980 and 1999 were studied. Data were collected from medical records. Histological sections from tumors and lymph nodes could be reviewed in 247 cases. Five-year disease-free survival rates were calculated using the Kaplan-Meier method and curves were compared using the log-rank test. Cox's proportional-hazards model was used for multivariate analysis. Recurrence risk was estimated using hazard ratios (HR). RESULTS: Forty-three recurrences were found. Multivariate analysis identified the following independent recurrence risk factors: number of metastatic pelvic lymph nodes (one lymph node: HR = 3.3 [1.3-8.3]; two or three: HR = 5.3 [1.5-18.6]; four or more: HR = 7.6 [1.7-33.2]), tumor invasion depth (deepest third: HR = 2.1 [1.1-4.1]) and inflammatory reaction intensity in the uterine cervix (absent or slight: HR = 2.5 [1.1-5.7]). CONCLUSION: This study identified that absent or slight inflammatory reaction was an independent risk factor for recurrence. The other risk factors were the number of metastatic pelvic lymph nodes and invasion of the deepest third of the uterine cervix.

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Section: Discussionmentioning

confidence: 56%